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International Journal of Medical Sciences And Clinical Research

Peer Reviewed | Open Access | E-ISSN: 2771-2265
Published Article

The Role Of SGLT-2 Inhibitors In Cardio-Renal Protection And The Management Of Type 2 Diabetes Mellitus

The Role Of SGLT-2 Inhibitors In Cardio-Renal Protection And The Management Of Type 2 Diabetes Mellitus

Authors

  • Shagazatova Barno Khabibullayevna
    Professor, Department of internal medicine, Endocrinology, Tashkent state medical university, Uzbekistan
  • Vafoyev Shakhzod Farhod ugli
    Assistant, Department of internal medicine, Endocrinology, Tashkent state medical university, Uzbekistan

DOI:

https://doi.org/10.37547/ijmscr/Volume05Issue10-03

Keywords:

Heart failure chronic kidney disease metabolic syndrome

Abstract

In recent years, sodium-glucose cotransporter type 2 (SGLT-2) inhibitors, a class of medications originally developed for managing type 2 diabetes mellitus (T2DM), have demonstrated significant benefits beyond glycemic control. These drugs have shown protective effects on both renal and cardiovascular systems, even in patients without diabetes. Researchers suggests that metabolic reprogramming plays a critical role in the progression of chronic heart failure (CHF) and chronic kidney disease (CKD). This reprogramming is associated with impaired cardiac energy metabolism due to a mismatch between glucose uptake and its oxidation, leading to the accumulation of glucose-6-phosphate (G6P), glycogen deposition, and activation of the pentose phosphate pathway. The consequence is mitochondrial dysfunction, oxidative stress and decreased fatty acid oxidation.

Similar mechanisms occur in the proximal tubules of the kidneys in CKD, resulting in tubular injury, albuminuria, and interstitial fibrosis. By inhibiting glucose and sodium reabsorption in the proximal tubules, SGLT-2 inhibitors increase glucosuria, induce mild osmotic diuresis and promote natriuresis. These processes yield anti-inflammatory effects, reduce oxidative stress and apoptosis, and further stimulate autophagy.

The additional effects include lowered blood pressure, decreased myocardial workload and reduced sympathetic nervous system activity. Additionally, SGLT-2 inhibitors improve tubuloglomerular feedback, reduce glomerular hyperfiltration and enhance erythropoiesis by mimicking systemic hypoxia. These mechanisms form the basis of the cardio- and nephroprotective effects of SGLT-2 inhibitors.

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